5/2 Mookitty AMPS:406, +1 274, +2 162, +3 107, +4 183 +10 Hi, PMPS 517, +1 417 +2 367 +3 281 +4 279

@Bron and Sheba (GA)

Dosed 1.25U this morning. Made a decent dent into half a can of Friskies this morning. Waiting on +1 measurement.

She was bright-eyed and talkative this morning. It is obvious she was feeling a lot better.

 

274

Offered higher carb food.
Measuring 30 minute interval because of the speed

 

Here is the link to your previous thread, so people have the history. Welcome to the L/L/B forum.

Can I ask why you gave higher carb food? Normally regular low carb food will work when in the 200's. I would also stay away from the dry food if you can. Test again in 1 hour.

 

Out of caution base on the rate of the drop. but I will withhold further higher carb food for now.

It is apparent the fast drop at the beginning on insulin does not sit well with her

 

At +1:30. 195

 

Could you update the spreadsheet with that 195? I'm a little worried about her getting too much food now and not being hungry later when you might want her to eat.

Although your spreadsheet says "don't know" for dosing method, this is a decision we will need you to make sometime soon. It impacts the suggestions we make to you.

 

+2 162

 

+3 107

 

@Wendy&Neko

Time to try to feed I think. If she goes an hour at this pace she will be in the 50s at +4. Im not comfortable with that.

 

Try a couple tsps of LC first.

 

+3:30 139 after low carb.

 

Perfect! This would a great place for her to hang out a while, the low carb can help them do that.

 

+4 183

 

You can slow down the testing now. If she's had nothing but low carb the last couple hours, then she's on her way up without influence of food. Maybe test in a couple hours now. If she's the same or above, you can stop testing until PMPS time.

 

Hi Ariah, I’m glad Mookitty is feeling better this morning. I hope you managed to get some sleep.
I see she is continuing to drop very early in the cycle. Have you managed to test for ketones today?.

@Wendy&Neko, the change over to the low carb food has made a big difference to the BGs. Ariah gave some higher carb food very early in the cycle yesterday because she accidentally gave 1.75 units in the am cycle instead of 1.25 when she was using the new 1/2 unit syringes for the first time and then in the pm cycle because of very recent DKA I wanted Ariah to still give the normal dose of 1.25 units and when Mookitty dropped 100 points at +1, I wasn’t sure what was ahead after the 1.75 dose and depot in the am, so suggested she give a teaspoon of higher carb food to slow the drop. That would be why she gave the higher carb food this morning when Mookitty dropped 130 points at +1.
Hindsight is a wonderful thing and I think Mookitty is a cat who is going to drop very early in the cycle so I agree that moving forward, low carb food will be best to give at +1 as she seems to drop early then slow down and flatten out.
We have been trying to get rid of all the dry food in the diet as I think she needs to follow TR with the very recent history of DKA and she is certainly testing enough.

 

@Bron and Sheba (GA) I figured it was something like that and I noticed the bump in dose yesterday. If she continues to be a fast drop kitty with just LC, some MC early on to slow the drop might be the next step. But let's try just low carb first and see how it goes.

 

I have slept and her ketones were negative today.

I wonder if her dropping early and the short effect of the lantus had anything to do with her thyroid levels. To me the problem seems to be the shortness of her cycle because she does go down low enough (she would drop below 100 without buffering and im not comfortable with that). During her DKA episode and during her hospital stay she was off methimazole. Transdermal Methimazole was reintroduced when she started lantus. I know methimazole has to build up in a cat's system and I also know during her last checkup her thyroid levels were borderline too high even with the current dosage of methimazole she had. Hyperthyroidism causes a more rapid removal of insulin and i would not be surprised at all of it had something to do with the more rapid drop.

She is going to have her thyroid checked within a few weeks and I'm going to ask the dosage be raised if it isn't closer to middle range. I want everyone to be wary of this because her high thyroid levels now are likely elevating her blood sugar values. When that stops if we have increased dosage rapidly at the same the risk of a hypo event increases. Fortunately, I believe methimazole will build over time so im expecting to see a lengthening of her cycle. I don't see it coming on suddenly.

My plan is to just follow @Bron and Sheba (GA) 's directions for the time being based on her DKA risk. I don't love tight regulation mostly because of the going below 100 thing. Im not comfortable with drops yet and i havent had a chance since last night to get her medium card food that she actually likes. The gravy food i have she might half heartedly lick. The only higher carb food she is enthusiastic about is meowmix. I don't believe the is any real risk of feeding her a teaspoon of dried cat food to slow a drop that doesn't appear to be slowing down. Hypo is more dangerous than dried cat food for now. I would rather feed my cat a donut than see her get close to 50 when I live with someone with a car but dont have one of my own. Keep in mind i offer the lower carb first so she would be having them together and the portion is tiny.

 

How much of a friskies can should i feed her before her shot?

 

Food on board:
Friskies Pate
Friskies in gravy 2.7% carb (surprised it is this low)
Hill's KD prescription Pate for hyperthyroidism: 43%.
Kitten meow mix
Syrup

I havent given the Hills Kd but i have it. In a pinch, it might be deluted with friskies because its mixable. Imagine vet mistaking a diabetic cat's weightloss for kidney disease and telling someome give your cat that. Poor Moobaby.)

 

I would feed her a normal meal size before the dose.

 

She behaves like a free range cat. Normally i give half a can, she wont eat all of that. If we are lucky half of it. I dont think it will be enough

 

I forgot: also have the DM food

 

Will she eat the rest after the shot if you leave the food down for her?

 

It varies. I think when her bg is higher she is more willing to pig out. Tonight she is eating what i give pretty quickly.

 

@Bron and Sheba should i give more than 1/2 can if she asks for it now or try to save her appetite for later in the cycle?

 

Sorry just seeing this. I would let her eat what she wants at preshot.
We need her to eat as much as possible at the moment because of the recent DKA. But we don’t want to fill her up too much early on incase we need her to be eating later….bit of a juggling act.

 

I can see she has dropped 100 points at +1. I would feed her some low carb food.

 

I did just a bit ago.
+2 367

 

+3 281

 

+ 4 279

 

What have you fed her this cycle?

 

Just low carb friskies

 

+4 and 25ish min
260

 

After the nadir of her last cycle and before PMPS she ate 1/3 of a can of friskies. This cycle she has eaten almost 1/2 a can.

 

Sounds like her appetite is a bit better. That’s good.

 

How will i know the nadir if she keeps eating?

 

+5 244

 

She doesnt seem to feel good when her blood sugar approaches healthier levels. When its in the 100s she gets so tired i could prop her. I think she has been diabetic for a long time..

 

Should I look into her potassium levels?

 

I’d get them checked next time you are getting a blood test. Or you could ask the vet where she was hospitalised if they did potassium levels. I’m sure they would have. Cats with low potassium often hang their heads and can have generalised muscle weakness.
Some cats do feel worse when their BGs are more normal because they are so used to the feeling of them being high. But that passes. Don’t forget she is still recovering from the DKA as well. She is having a longer duration tonight.

 

+6 239

 

Feeding her more too

 

This might be helpful to determine which wet kitty food to use:

https://catinfo.org/chart/index.php

 

Friskies Gravy Sensations range from 14-20% Carbs, if this is correct: https://catinfo.org/chart/index.php

 

yeah I find it very hard to believe that Friskies in GRAVY is LC

 

That's quite common at this stage. Think of the high blood sugar like coffee. She's used to quite a bit in her blood stream. With insulin, she's getting less and feeling the same you might if you were cutting back caffeine. My girl used to be happiest and playful when over 300. The first time she was under 100 she hid under the bed. Over time she got used to lower numbers and low 100's were her play zone.